Editorial EDITOR Nick Lipley Tel: +44 (0)20 8872 3166 Email: [email protected] EDITORIAL ADVISORY BOARD Jim Bethel Senior lecturer and nurse practitioner in emergency care, University of Wolverhampton Hannah Bryant Resuscitation officer, Queen Elizabeth Hospital, Birmingham Jennifer Critchley Urgent care centre emergency nurse practitioner, Benalla, and senior lecturer, University of Melbourne, Victoria, Australia Shelley Cummings Professional lead for safeguarding, Ashford and St Peter’s Hospitals NHS Trust, Surrey Rachel Lyons Associate clinical professor of nursing, Rutgers University, Newark NJ Lorna McInulty Senior lecturer in emergency and unscheduled care, University of Central Lancashire Mike Parker Lecturer in clinical nursing at the University of York Mike Paynter Consultant nurse, Somerset Partnership NHS Foundation Trust Andrew Rideout Advanced nurse practitioner, emergency department, Dumfries and Galloway Royal Infirmary Linsey Sheerin Lead nurse in emergency care at Antrim Area Hospital, Northern Health and Social Care Trust

How do we fix emergency care? What a winter it has been for emergency care services: possibly the worst for a generation, with four-hour operational standards being missed and huge pressure heaped on healthcare staff across the UK. Once again, patients have been waiting for more than 12 hours at a time and trusts have been declaring major incidents, and the usual explanations have been given: an ageing population, lack of access to services and lack of collaboration between care sectors (analysis, pages 8-9 and 11).

Acting assistant editor Jennifer Sprinks Tel: +44 (0)20 8872 3148 Email: [email protected] Production editor Duncan Tyler Tel: +44 (0)20 8872 3133 Email: [email protected] Administration manager Helen Hyland Email: [email protected] Administration assistant Sandra Lynch BUSINESS UNIT Display advertisements Tel: +44 (0)20 8872 3123 Classified advertisements Tel: +44 (0)20 8423 1333

But it is not as if the situation was unforeseen. Back in October, RCN acute and emergency care adviser JP Nolan warned that a ‘perfect storm of unfavourable conditions’ was coming. Even over the summer, the Society of Acute Medicine and the College of Emergency Medicine said that overcrowding and ‘exit block’ were putting lives at risk.

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Nor is it as if we are unacquainted with these factors. The question we must answer now is not one of what we must do but of how we do it.

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Once again, patients have been waiting for more than 12 hours at a time and the usual explanations have been given

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Nick Lipley Editor

As ever, the answers are likely to come from front line staff, which is why I welcome the RCN Emergency Care Association’s decision to hold its annual conference next month, rather than in the autumn (diary, page 16). No doubt, the difficulties faced by emergency nurses across the country in recent months will feature highly at the conference in Manchester, as will the latest proposals from the National Institute for Health and Care Excellence on emergency department staffing levels (news, page 7). With a general election in May, the conference offers us a rare opportunity to discuss how to engage parliamentary candidates in debate about emergency care services, and to gain their support for how we want to improve them. Also next month, senior lecturer and emergency care research lead at the University of Hertfordshire Tricia Scott takes up post as the new consultant editor of Emergency Nurse. I am sure you will join me in welcoming her to the role and will support her with your ongoing contributions to the journal.

Our mission Emergency Nurse encourages innovation and promotes professional excellence in all pre-hospital and emergency care settings. The journal is editorially independent and opinions expressed in it do not necessarily reflect the policies of the Royal College of Nursing or those of contributors’ employing organisations.


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Visit us at: Emergency Nurse February 2015 | Volume 22 | Number 9

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How do we fix emergency care?

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